Consensus
Individuals and families across the United States face growing challenges in accessing timely, high-quality primary care, which is essential to overall health and well-being. The delivery of such care is becoming more complex, placing undue strain on primary care clinicians and exacerbating existing workforce shortages.
A National Academies committee recently examined the inputs and functions needed for interprofessional teams to successfully and sustainably deliver high-quality primary care. The committee concluded the nation must support the primary care workforce through appropriate and supportive payment; hold payers, states, and health systems accountable in ensuring that such payment reaches primary care practices; and sufficiently train an interprofessional workforce. This report offers nine specific recommendations for how federal agencies and other key players can better support the provision of high-quality, interprofessional, team-based primary care.
58 pages
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ISBN Paperback: 0-309-99564-7
ISBN Ebook: 0-309-99565-5
DOI:
https://doi.org/10.17226/29226
National Academies of Sciences, Engineering, and Medicine. 2025. Building a Workforce to Develop and Sustain Interprofessional Primary Care Teams. Washington, DC: The National Academies Press.
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Workshop
Pharmacy plays a critical role in improving patient outcomes and strengthening health systems. In May 2025, the National Academies convened leaders in pharmacy education, practice, policy, and industry for a two-day workshop to examine how the profession has evolved to meet changing health care demands. Presenters and participants explored strategies to address "pharmacy deserts" and expand equitable access to pharmacy services through financially sustainable practice models for pharmacist services; approaches for fostering well-being and resilience in the pharmacy workforce; models for financial sustainability that could address pharmacist burnout, declining enrollment, and community pharmacy closures; and next-generation education and training programs to prepare pharmacists for diverse and emerging roles. This Proceedings of a Workshop summarizes discussions and presentations from the workshop.
194 pages
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ISBN Paperback: 0-309-99576-0
ISBN Ebook: 0-309-60117-7
DOI:
https://doi.org/10.17226/29229
National Academies of Sciences, Engineering, and Medicine. 2025. Innovations in Pharmacy Training and Sustainable Practice to Advance Patient Care: Proceedings of a Workshop. Washington, DC: The National Academies Press.
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Consensus
Military families raising children with autism often face unique challenges in accessing consistent, high-quality care across frequent moves and deployments. Applied behavior analysis, or ABA, is widely recognized as an effective intervention for many autistic individuals, yet military families report barriers that delay or restrict their access to these services.
The report The Comprehensive Autism Care Demonstration: Solutions for Military Families examines how the Department of Defense's autism care demonstration program is serving families and whether ABA should be covered as a TRICARE Basic benefit. Drawing on a careful review of the scientific literature, the report finds that ABA meets the Department's own standards for reliable medical evidence and should be formally authorized as a TRICARE Basic benefit.
The report identifies key areas where current demonstration policies differ from clinical standards. These include restrictive rules around assessments, limited flexibility in treatment goals and settings, and administrative requirements that impose unnecessary burdens on both families and ABA providers.
336 pages
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ISBN Paperback: 0-309-99314-8
ISBN Ebook: 0-309-99315-6
DOI:
https://doi.org/10.17226/29139
National Academies of Sciences, Engineering, and Medicine. 2025. The Comprehensive Autism Care Demonstration: Solutions for Military Families. Washington, DC: The National Academies Press.
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Workshop
Traumatic brain injury (TBI) can have lasting physical, cognitive, and emotional health effects that extend well beyond the initial event. In March 2025, the National Academies' Forum on Traumatic Brain Injury convened a workshop to explore TBI as a chronic condition and to identify opportunities to improve lifelong care.
Participants examined evidence supporting the classification of TBI as a chronic condition, explored the biological mechanisms that drive long-term outcomes, and discussed the complex comorbidities that can persist or emerge years after injury. Lived experience perspectives shared throughout the workshop underscored the human impact of these issues and the importance of sustained, multidisciplinary support for recovery and well-being. This Proceedings of a Workshop summarizes presentations and discussions from the workshop.
124 pages
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ISBN Paperback: 0-309-60041-3
ISBN Ebook: 0-309-60039-1
DOI:
https://doi.org/10.17226/29230
National Academies of Sciences, Engineering, and Medicine. 2025. Examining Traumatic Brain Injury as a Chronic Condition: Proceedings of a Workshop. Washington, DC: The National Academies Press.
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Workshop_in_brief
Labor and employment policies impact where people live and work, as well as their access to health care and overall well-being. The National Academies' Roundtable on Population Health Improvement held a public workshop in June 2025 to examine the specific ways in which these policies influence health outcomes and health equity across communities. Discussions addressed the impact of larger trends shaping the modern labor market, such as automation and gig work, on health and economic security; effects of unemployment insurance, paid leave, wage laws, and scheduling protections; and more. This Proceedings of a Workshop-in Brief summarizes presentations and discussions from the workshop.
14 pages
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ISBN Ebook: 0-309-60082-0
DOI:
https://doi.org/10.17226/29281
National Academies of Sciences, Engineering, and Medicine. 2025. Exploring Relevant Policy Domains: Labor and Employment Policy and Population Health: Proceedings of a Workshop—in Brief. Washington, DC: The National Academies Press.
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The affordability of health professional education (HPE) is a critical issue in the U.S., with rising costs and mounting debt impacting who can enter and sustain health professional careers. The National Academies Global Forum on Innovation in Health Professional Education convened a workshop series in early 2025 to examine financial barriers, assess workforce effects, and consider strategies to improve the value and accessibility of HPE. Policy experts, educators, students, and international stakeholders discussed topics such as financing and payment models that influence access to HPE programs; the impact of debt on students' decisions to enter primary care or practice in rural and underserved areas; and return on investment considerations for HPE programs and their implications for individuals, institutions, and society. This Proceedings of a Workshop-in Brief summarizes presentations and discussions that took place across the series.
11 pages
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ISBN Ebook: 0-309-60045-6
DOI:
https://doi.org/10.17226/29271
National Academies of Sciences, Engineering, and Medicine. 2025. Affordability of Health Professional Education: Proceedings of a Workshop Series—in Brief. Washington, DC: The National Academies Press.
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Consensus
The Centers for Disease Control and Prevention's (CDC) Immunization Safety Office (ISO) is responsible for studying vaccine risks once vaccines are administered to the public. During the COVID-19 pandemic, ISO played a central role in vaccine safety evaluation.
At the request of the CDC, the National Academies convened an expert committee to assess the ISO's statistical and epidemiological methods in vaccine risk monitoring and evaluation, including processes designed to detect, evaluate, and report potential problems associated with COVID vaccines. The committee also evaluated CDC's external communication strategies and provided recommendations to sustain and enhance ISO's vaccine risk monitoring and communication systems. The resulting report presents the committee's conclusions and recommendations.
252 pages
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ISBN Paperback: 0-309-53979-X
ISBN Ebook: 0-309-59410-3
DOI:
https://doi.org/10.17226/29240
National Academies of Sciences, Engineering, and Medicine. 2025. Vaccine Risk Monitoring and Evaluation at the Centers for Disease Control and Prevention. Washington, DC: The National Academies Press.
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Rapid_expert_consultation
Diagnostics are the first line of defense to infectious disease outbreaks. The rapid spread of Influenza A (H5N1) or "Bird Flu" into U.S. dairy cattle, poultry, and humans underscores the urgent need for stronger diagnostic readiness. While sustained human-to-human transmission has not yet occurred with H5N1, the risk is growing. Currently there are knowledge gaps around early case identification measures, clinical management, and coordinated public health efforts.
In response, the National Academies produced a rapid expert consultation providing a strategic and actionable analysis for strengthening domestic diagnostic capacity and infrastructure. This is the first publication of the institution's new Rapid Response to Emerging Science, Engineering, and Medicine Challenges initiative, which provides a formal platform for proactively building sustainable, crosscutting rapid response capabilities.
36 pages
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ISBN Ebook: 0-309-60052-9
DOI:
https://doi.org/10.17226/29273
National Academies of Sciences, Engineering, and Medicine. 2025. Diagnostic Tools, Gaps, and Collaborative Pathways in Human H5N1 Detection: Rapid Expert Consultation. Washington, DC: The National Academies Press.
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Tobacco use and alcohol use place first and third, respectively, as leading modifiable risk factors for cancer cases and deaths in the US. Our National Cancer Policy Forum convened a public workshop in March 2025 to examine current evidence on the health outcomes of tobacco and alcohol use, including their synergistic effects. Participants explored the state of research on tobacco and alcohol as cancer risk factors and differences in outcomes across U.S. populations. Speakers discussed potential strategies, such as community engagement and public health messaging, to reduce tobacco and alcohol use to lower cancer risk and improve health outcomes for all. This Proceedings of a Workshop summarizes presentations and discussions from the workshop.
76 pages
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ISBN Paperback: 0-309-60011-1
ISBN Ebook: 0-309-59987-3
DOI:
https://doi.org/10.17226/29264
National Academies of Sciences, Engineering, and Medicine. 2025. Addressing the Impact of Tobacco and Alcohol Use on Cancer-Related Health Outcomes: Proceedings of a Workshop. Washington, DC: The National Academies Press.
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Military personnel, who are often exposed to a variety of hazards while deployed, have expressed concerns that mental, behavioral, and neurologic health issues may arise from these exposures. The U.S. Department of Veterans Affairs, in accordance with Section 507 of the Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics Act of 2022 (PACT Act), requested that the National Academies convene a committee of experts to assess possible relationships between exposures experienced during military service and mental, behavioral, and neurologic health conditions and chronic multisymptom illness. Consistent with the PACT Act, the committee focused on veterans deployed to the Southwest Asia Theater of Operations or Afghanistan after September 11, 2001. The resulting report offers conclusions regarding possible risk-conferring relationships between nine categories of exposures and health outcomes including depression, anxiety, and dementia.
370 pages
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ISBN Paperback: 0-309-99536-1
ISBN Ebook: 0-309-99537-X
DOI:
https://doi.org/10.17226/29219
National Academies of Sciences, Engineering, and Medicine. 2025. Exploring Military Exposures and Mental, Behavioral, and Neurologic Health Outcomes Among Post-9/11 Veterans. Washington, DC: The National Academies Press.
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Consensus
The Manhattan Project was a large-scale, top-secret program of the U.S. federal government created with the specific purpose of developing the world's first nuclear weapon. Each step of the manufacturing process involved potential exposures to chemical and radiological hazards for those involved. Records documenting Manhattan Project processes, activities, and individual people were not uniform, archived in various locations, and at times destroyed due to both administrative and accidental reasons, resulting in a fragmented historical record of the people and activities.
Given these uncertainties, the U.S. Department of Veterans Affairs asked the National Academies to conduct a feasibility assessment to determine whether an epidemiologic study could be conducted to examine health outcomes in active-duty military veterans who participated in the Manhattan Project at 13 specified sites. The resulting report offers conclusions on the feasibility of conducting such a study and provides alternative methods to examine associations between exposures and adverse health outcomes among this population of veterans.
270 pages
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ISBN Paperback: 0-309-99504-3
ISBN Ebook: 0-309-73134-8
DOI:
https://doi.org/10.17226/28585
National Academies of Sciences, Engineering, and Medicine. 2025. Evaluation of Manhattan Project Records for Veteran Health and Exposure Assessments. Washington, DC: The National Academies Press.
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Workshop_in_brief
Empathy and compassion shape how people build relationships, care for one another, and respond to suffering. Yet, the biological mechanisms that underlie these traits and their influence on brain health are not fully understood.
The National Academies Forum on Neuroscience and Nervous System Disorders, in collaboration with the Board on Behavioral, Cognitive, and Sensory Sciences, convened a two-day virtual workshop in May 2025 to explore the underlying neurobiology of empathy and compassion; consider the influence of social interactions, psychological states, and the environment; and explore how this knowledge may be harnessed to treat brain disorders and foster human well-being. This Proceedings of a Workshop-in Brief outlines presentations and discussions that occurred during the workshop, including perspectives from individuals with lived experience, neuroscientists, and health care professionals, including psychologists.
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ISBN Ebook: 0-309-60034-0
DOI:
https://doi.org/10.17226/29238
National Academies of Sciences, Engineering, and Medicine. 2025. Unraveling the Neurobiology of Empathy and Compassion: Implications for Treatments for Brain Disorders and Human Well-Being: Proceedings of a Workshop—in Brief. Washington, DC: The National Academies Press.
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The scientific community has been studying the question of how human-caused emissions of greenhouse gases are affecting the climate for well over a century. Much is known today, drawing on decades of direct observations of the Earth system and detailed research. This report summarizes the latest evidence on whether greenhouse gas emissions threaten public health and welfare in the United States.
The impetus for this report was a notice of proposed rulemaking issued in August 2025 by the U.S. Environmental Protection Agency (EPA) indicating its intention to rescind the 2009 Finding of Endangerment and Cause or Contribute Findings for Greenhouse Gases Under Section 202(a) of the Clean Air Act. Recognizing that significantly more evidence is available today, the National Academies of Sciences, Engineering, and Medicine launched this study to review newly available scientific evidence on the topics included in a Technical Support Document that EPA prepared to inform its decision-making on the finding.
The report’s authoring committee found that EPA’s 2009 finding that human-caused emissions of greenhouse gases adversely affect human health and welfare was accurate, has stood the test of time, and is now reinforced by even stronger evidence. Today, many of EPA’s conclusions are further supported by longer observational records and multiple new lines of evidence. Moreover, research has uncovered additional risks that were not apparent in 2009.
126 pages
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ISBN Paperback: 0-309-99603-1
ISBN Ebook: 0-309-60029-4
DOI:
https://doi.org/10.17226/29239
National Academies of Sciences, Engineering, and Medicine. 2025. Effects of Human-Caused Greenhouse Gas Emissions on U.S. Climate, Health, and Welfare. Washington, DC: The National Academies Press.
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Rising rates of stress, anxiety, and depression highlight the need to understand how the brain builds resilience across life stages. The National Academies' Forum on Neuroscience and Nervous System Disorders, in collaboration with the Forum on Mental Health and Substance Use Disorders, hosted a workshop in March 2025 to explore the neurobiological mechanisms of stress; critical periods for resilience development; and strategies to apply these insights in clinical, public health, and community-based approaches. This Proceedings of a Workshop highlights presentations and discussions that occurred at the workshop.
114 pages
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ISBN Paperback: 0-309-59922-9
ISBN Ebook: 0-309-59920-2
DOI:
https://doi.org/10.17226/29243
National Academies of Sciences, Engineering, and Medicine. 2025. Applying Neurobiological Insights on Stress to Foster Resilience Across Life Stages: Proceedings of a Workshop. Washington, DC: The National Academies Press.
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In July 2025, the Centers for Medicare & Medicaid Services solicited public comments on proposed policy changes for Medicare payments under the Physician Fee Schedule - and other Medicare Part B components - set to take effect on or after January 1, 2026. The National Academies convened a committee of experts in relevant fields to respond to the changes and outline specific recommendations. The resulting report addresses topics such as valuation of primary care services, management and prevention of chronic disease, and health coaching and motivational interviewing.
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ISBN Ebook: 0-309-59984-9
DOI:
https://doi.org/10.17226/29259
National Academies of Sciences, Engineering, and Medicine. 2025. Response to the Centers for Medicare & Medicaid Services CY 2026 Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies Proposed Rule. Washington, DC: The National Academies Press.
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This is the first of two reports requested by the Social Security Administration (SSA) to address best practices and community experiences in the management and treatment of sickle cell disease (SCD). SCD, a group of inherited blood disorders affecting approximately 100,000 people in the United States, is a chronic, life-long condition that affects every organ system in the body. The life of an individual with SCD is often complicated by frequent bouts of extreme pain and hospitalizations, fatigue, organ damage, and mental health conditions. The cumulative burden of SCD-related health effects can significantly affect quality of life, including the ability to regularly attend and participate fully in school and work.
In response to SSA's request, the National Academies of Sciences, Engineering, and Medicine convened an expert, ad hoc committee to review the latest published scientific research and generate findings and conclusions on a variety of topics related to SCD. This report is the first report in a two-report series, and presents the committee's findings and conclusions pertaining to SCD pain crises, pain management, and treatment settings relevant to SSA disability determinations.
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ISBN Paperback: 0-309-99306-7
ISBN Ebook: 0-309-99307-5
DOI:
https://doi.org/10.17226/29137
National Academies of Sciences, Engineering, and Medicine. 2025. Sickle Cell Disease in Social Security Disability Evaluations: Pain and Treatment Settings. Washington, DC: The National Academies Press.
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The United States is a global leader in biomedical research, generating therapeutic breakthroughs that advance the health of the nation and the world. The public and private sectors contribute to this advancement by funding biomedical research and development. The current level of investment in pharmaceutical development in the United States, while substantial, does not always yield desired health outcomes or meet the needs of patients. Public and private funders face a myriad of challenges that affect their funding decisions and hinder the ability of the drug development system to prioritize disease burden and unmet need - often leaving critical gaps in available treatment options.
To better understand these gaps, Gates Ventures and the Peterson Center on Healthcare asked the National Academies to examine current challenges and offer strategies and recommendations for improvement. The resulting report emphasizes that current research prioritization does not systematically account for disease burden and unmet needs, and describes how a robust, timely, accessible data system is needed. It also explores the ways in which implementing recommended policy changes could deliver better health outcomes.
246 pages
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ISBN Paperback: 0-309-99382-2
ISBN Ebook: 0-309-99383-0
DOI:
https://doi.org/10.17226/29157
National Academies of Sciences, Engineering, and Medicine. 2025. Aligning Investments in Therapeutic Development with Therapeutic Need: Closing the Gap. Washington, DC: The National Academies Press.
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Workshop_in_brief
Structural and systemic barriers continue to limit access to high-quality mental health and substance use disorder (MHSUD) care, particularly in underserved communities. Understanding how health and human services influence care delivery is essential to improving outcomes.
In July 2025, the National Academies Forum on Mental Health and Substance Use Disorders hosted a public workshop to explore how infrastructure, policies, and structural determinants of health such as housing and food security impact the accessibility, quality, and coordination of MHSUD services. Participants discussed various ways to operationalize promising practices, as well as strategies for uplifting community voices and strengthening accountability across the health and social sectors. This Proceedings of a Workshop-In Brief summarizes the presentations and discussions from the two-day event.
16 pages
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ISBN Ebook: 0-309-59919-9
DOI:
https://doi.org/10.17226/29242
National Academies of Sciences, Engineering, and Medicine. 2025. Enhancing Care and Services for Mental Health and Substance Use Disorders: Proceedings of a Workshop—in Brief. Washington, DC: The National Academies Press.
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